Gary Chen MD, Presenter: Nothing to Disclose

Mahendra B. Shah, Abstract Co-Author: Nothing to Disclose

To describe the prevalence of clinically significant incidental findings of abdominal and thoracic CT examinations performed in the emergency department. The clinical course and frequency of documented follow-up examination was recorded.

One hundred fifty-one consecutive CT examinations performed on 147 patients during a single month in a university hospital ED were reviewed. Two patients were excluded secondary to incomplete clinical data. Radiology reports and patient charts were reviewed to separate patients into trauma vs. non-trauma indications for presentation. CT results were classified as significant incidental finings if they were not previously known to the patient, not directly linked to the clinical presentation or symptoms, and significant enough to warrant further imaging, clinical studies, or cause anxiety to the patient. Radiographic follow-up of incidental findings was determined one year following initial presentation.

One hundred forty-five patients had 149 examinations (46 CT Thorax, 90 CT Abd/Pelvis, and 13 non-contrast CT Abd/Pelvis). Thirty-one scans were performed on trauma patients and 118 scans were performed on non-trauma patients. Fifty men and 95 women were included with a mean age of 44, and age range of 9-84. Twenty-four out of 145 patients (17%) had incidental findings, with only 1 documented follow-up examination performed out of 19 suggested follow-ups.

Incidental findings are relatively common on CT examinations performed in the emergency department. However, most follow-up is deferred to a future date and many patients are lost to follow-up. This may have important consequences for whole body screening CT, as many patients with findings are not treated and may not receive follow-up care.

Chen, G, Shah, M, Incidental Findings of CT Scans of Patients Presenting to the Emergency Department.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4407788.html